SPORTS MEDICINE 20 Giesbrecht Injury Management 1 Definition

SPORTS MEDICINE 20 Giesbrecht Injury Management 1

Definition of Sports Medicine An area of health & special services that applies medical and scientific knowledge to: Prevent Recognize Manage Rehabilitate Injuries and illnesses related to sport, exercise or recreation activity

Members of a Sports Medicine Team Physicians & Athletic Trainers primarily responsible for the health and safety of sports participants Essential to the prevention & care of sports injuries Educate & counsel sport participants to prevent chronic injuries

Code of Ethics of an Athletic Therapist Respect the rights, welfare & dignity of all individuals Comply with local, provincial and federal & institutional guidelines Maintain & promote high standards in the provision of their services Do not engage in conduct that could be construed as a conflict of interest

Toolbox Item Why is this code so important to follow as an Athletic Trainer? Give 3 reasons.

Observing as a Fan or Athletic Trainer? Fans enjoy the excitement of the game They can enjoy the collisions, speed and complexity of the game from a purely entertainment point of view Athletic Trainers must observe the game from a more clinical approach Anticipating collisions Looking for potentially dangerous situations that arise Mechanism of injury is very important in determining what has happened to an athlete

Liability Issues for Athletic Trainers Informed consent & participant risks Duty to properly assess the athlete’s condition Duty to properly provide or refer the athlete for medical treatment Duty to ensure that there has been proper clearance for the athlete to participate or to return to participation and that the athlete has been properly advised of any risks of participation

Toolbox Item What are the consequences of not paying attention to Liability Issues as an Athletic Trainer? Provide Outline at least 2 consequences. the severity of each consequence.

Pre Participation Medical Info Form Having a medical completed by athletes reveals any major concerns with health that an athlete may have before starting Football Medicals provide our training staff vital info about an ahtletes’ medical states before competition Having Par Q forms helps inform Athletic Therapists about pre existing conditions that participants may have by completing a Questionnaire The Par Q form you all filled out gives me an idea

Toolbox Item What do we do at Le. Boldus to cover this area? Think Wellness Center as well as any other participation class.

Safety of playing areas Ensure that: the playing area is level, firm and free from obstructions (for example, holes or exposed sprinkler heads) permanent fixtures such as goal posts are padded, flexible and highly visible there is adequate lighting if playing at night perimeter fences are well back from the playing area spectators are kept well away from the playing area.

Facility Assessment Use the information from the previous slide to assess the following facilities in the school and area. Wellness Center Large Gym Football Field Baseball Diamond

Check that protective equipment: is worn by participants during training and competition fits the participant correctly is regularly checked and maintained is specific and appropriate for the sport, size and age of the participant is being used according to the manufacturer’s guidelines and the recommendations of the governing sporting body. What do we do at Le. Boldus with our Equipment?

Factors affecting athletes An athletic therapist must know how the following factors affect athletes: Weather Hypothermia Hyperthermia Clothing protection Rinks/ pools

In hot or humid conditions: Encourage participants to wear loose, lightweight, light-coloured clothing made from a natural fibre Avoid intense activity in hot or humid conditions and monitor participants carefully for signs of heat illness. Help participants avoid sunburn by encouraging them to slip on a t-shirt, slop on some sunscreen and slap on a hat. Encourage participants to drink plenty of fluid before the activity begins and schedule regular

In cold and/or wet conditions: Encourage participants to wear clothing appropriate for cold conditions (for example, dress in layers to trap heat, wear gloves and a hat to reduce heat loss). Avoid participants standing exposed to the cold for long periods. Encourage participants to change wet clothing as soon as practicable. Alternative venues (for example, indoors) should also be considered, to ensure the safety and wellbeing of participants.

The environment can lead to injury For example: Cool wet weather (hypothermia) Warm humid weather (hyperthermia) Lightning or tornados Carbon monoxide poisoning (rinks) Chlorine leakage (pools) Sunburn Other examples? ? What do we do at Le. Boldus with regard to some of these environmental

What is normal? Normal body temperature is 37. 5 C Any variation of the norm can be extremely dangerous and can result in death! Hyperthermia and hypothermia are two conditions an Athletic Therapist must be aware of.

Stages of Hyperthermia There are 3 categories of increasing severity: Heat illness Heat exhaustion Heat Stroke

Causes of heat emergencies High temperatures or humidity Prolonged or excessive exercise Medications/ alcohol use Track and field/ football/ fun runs Playing with a fever Dehydration Excessive clothing CV disease/ sweat gland dysfunction Whirlpools/ saunas

Heat Illness (early stage) signs and symptoms Profuse sweating Fatigue Thirst Muscle cramps

Heat Exhaustion (late stage) signs and symptoms Headache Dizziness Light headedness Weakness Nausea Vomiting Cool moist skin Dark urine

Heat Stroke (good luck stage) signs and symptoms Fever Irrational behavior Extreme confusion Dry hot red skin Rapid shallow breathing Rapid weak pulse Seizures unconsciousness

What to do in case of Emergency How should an Athletic Therapist handle these situations? • Water (1/2 cups per 15 min) • Gatorade • Salty drink (1 tsp salt per quart of water

Handling Emergencies (con’t) For cramps – massage gently, but firmly until they relax If signs of shock/ cyanosis/ decreased alertness, confused/ seizures/ loss of consciousness/ or person does not improve or gets worse--- All 911 immediately!

Some DO NOT’s DO NOT underestimate the seriousness of heat illness especially if the person is a child, elderly or injured. DO NOT give the person medications to treat fever (aspirin, acetaminophen) which may actually cause harm. DO NOT give person salt tablets/ alcohol/ caffeine DO NOT give anything by mouth if person is vomiting or loss of consciousness

Hypothermia Hypothermia is dangerously low body temperature (below 35 C) It occurs when body loses more heat than it can generate Can be FATAL!

Cause of Cold Emergencies Being outside without enough protective clothing in the winter Wearing wet clothing in windy or cold weather Swimming pools or ocean/ falling overboard from boat into cold water Heavy exertion, not drinking enough fluids, not eating enough in cold weather Cross country or downhill skiing/ hockey Soccer/ rugby (wet/ windy sidelines) Does not have to be cold weather

Signs and Symptoms Drowsiness Weakness Loss of coordination Confusion Pale and cold skin Slowed breathing/ heart rate Uncontrollable shivering (shivering may stop at extremely low body temperatures)

What to do in case of Emergency If any symptoms are present, especially unconsciousness, confusion or changes in mental status, immediately call 911 and perform the ABC’s (airways, breathing, and circulation) Take person inside to room temperature and insulate them with warm blankets, if outdoors insulate from ground and cover head and neck to retain heat.

What to do… (con’t) Remove wet or constricting clothing and replace with dry clothing Warm person – use warm compresses to neck, chest wall, groin, if necessary use your own body heat to warm person If alert and can swallow, have them sip warm sweetened fluids

Some DO NOTS… DO NOT assume that someone found motionless in the cold is already dead DO NOT use direct heat (hot water, heating pad, heat lamp) to warm person DO NOT give the person alcohol

Frostbite

Frostbite Frostbite is damage to the skin and underlying tissues caused by extreme cold over a period of time A person with frostbite may also be subject to hypothermia Check for hypothermia and treat that first

Frostbite Signs & Symptoms Hands, feet, nose and ears are most vulnerable Hard pale and cold quality of skin exposed to cold for length of time Area lacks sensitivity to touch, although there may be aching pain As area thaws, flesh becomes red and very painful, tingling, burning

Some DO NOT’s … DO NOT thaw an area if it cannot be kept thawed Re-freeze may make damage worse DO NOT use direct heat (radiator, campfire, heating pad, hair dryer) to thaw area DO NOT rub or massage affected area DO NOT disturb blisters on skin DO NOT smoke or drink alcohol during recovery

Frostbite Treatment Warm the affected area with body heat, but avoid rubbing the area—it can damage tissue. Don’t use hot water or other external heat sources, which could cause burns. Wrap with warm, dry clothing. Get to a warm shelter. Drink hot liquids. Get medical attention.

Emergency Action Plan A plan that is in place in case EMS has to be activated Each Plan should have a designated way for EMS to access the injured athlete [A map can be helpful] Each plan should have someone designated as a CALL PERSON The CALL PERSON calls EMS & Waits at the EMS meeting point to guide EMS to the injured athlete Each plan should have someone designated as a CHARGE PERSON The CHARGE PERSON waits with the injured athlete, taking charge of the injured athlete and providing ongoing care for the athlete

Injury Categories Life Threatening Activate EMS Activate Emergency Action Plan Provide immediate emergency first aid Continue Serious Provide until EMS arrives immediate emergency first aid Non Life Threatening Evaluate and treat as time allows

Evaluate Injury Scenarios Differentiate between injury categories Life Threatening Provide 2 examples of what kind of injuries these might be Serious Provide 2 examples of what kind of injuries these might be Non Life Threatening Provide 2 examples of what kind of injuries these might be

Injury Categories Acute Occur suddenly during activity Examples include: Ankle Sprains, Bone Fracture, etc Chronic Occur as a result of overusing an area Often an athlete will ignore signs the body is giving them telling them something is wrong Often athletes will play through minor injuries without getting treatment on them after resulting in a chronic injury Recurrent Injury injury re occurs after an athlete recovers from the

Examples of different Injuries Provide one example of each of the following injuries: Acute Injury Chronic Injury Recurrent Injury

Mechanisms of Injury Direct Blow A Force is applied to a part of the body Causes Torsion Load application with axial rotation Force beaks and contusions (Internal Bleeding) onto twisting Shearing One part of the body is going one way overtop of another part of the body going the other way ACL injuries are quite often shearing Brain injuries are quite often shearing Bending & Twisting of Bones An Athlete gets bent over and something gives

Examples of Mechanisms of Injuries Give two examples of each of the 4 Mechanisms of injury: Direct Blow Torsion Shearing Bending and Twisting of bones

Phases of the Injury Cycle Inflammatory Phase SHARP accronym: Swelling-Heat-Altered Fucntion-Redness-Pain Natural response of the body to protect the injury site Repair & Regeneration Phase Body starts to grow new tissue and repairs damaged tissue New tissue is easily reinjured Remodelling Phase Retraining the injured part through controlled full movements New tissue needs to be trained Scar tissue needs to released

Roles & Responsibilities of Athletic First Aider Prevent Recognize injuries Correct diagnosis Manage Assessment of athletes strengths & weaknesses Program design to prevent injury Take care of immediate injury situations Rehabilitate Follow through with care after initial diagnosis and management of injury Plan for a healthy recovery of athlete from injury

Bones of the Ankle

Anatomy of an Inversion Ankle Sprain

Bones of the Wrist/Hand